Fuel-a-Thon Submission Form

The Fuel-a-Thon helps us close the gap between your fees ($3,475) and what we spend ($7,000) per member.

Directions: Provide 20 names and mailing addresses of individuals over the age of 21. We will solicit them on your behalf to make a donation to our Fuel-a-Thon. Of the donations received, 25% will be credited to your account. Think of all of the people who you know: aunts/uncles, grandparents, friends’ parents, your parents’ work colleagues, parents’ friends, neighbors, etc.

NOTE: Pacific Crest will NOT solicit these individuals again unless they are already in our database or make a purchase via our online store. You may “buy out” this obligation by making a $100 donation to Pacific Crest (see the green button below).

Fuel-a-Thon Buy-Out →

Take care when filling-in the information. All rows must be completed before the form may be submitted. It is best to have all of the information assembled prior to filling-in the form.

Pacific Crest Member Info
Last Name: First Name: Email:
  Name Company "Dear" Name Street Address City State Zip
Ex1 Jane and Bob Smith   Grandma and Grandpa 123 South Main Street AnyCity CA 90000
Ex2 John Bell Pizza Bell Mr Bell 555 Pizza Street AnyCity CA 91234
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